John Barrasso on Health Care Republican Appointee

Ensure Wyoming is fairly reimbursed by Medicare and Medicaid

Voted YES on means-testing to determine Medicare Part D premium.

SUPPORTER'S ARGUMENT FOR VOTING YES:Sen. ENSIGN: This amendment is to means test Medicare Part D the same way we means test Medicare Part B. An individual senior making over $82,000 a year, or a senior couple making over $164,000, would be expected to pay a little over $10 a month extra. That is all we are doing. This amendment saves a couple billion dollars over the next 5 years. It is very reasonable. There is nothing else in this budget that does anything on entitlement reform, and we all know entitlements are heading for a train wreck in this country. We ought to at least do this little bit for our children for deficit reduction. OPPONENT'S ARGUMENT FOR VOTING NO:Sen. BAUCUS: The problem with this amendment is exactly what the sponsor said: It is exactly like Part B. Medicare Part B is a premium that is paid with respect to doctors' examinations and Medicare reimbursement. Part D is the drug benefit. Part D premiums vary significantly nationwide according to geography and according to the plans offered. It is nothing like Part B.

Second, any change in Part D is required to be in any Medicare bill if it comes up. We may want to make other Medicare changes. We don't want to be restricted to means testing.

Third, this should be considered broad health care reform, at least Medicare reform, and not be isolated in this case. LEGISLATIVE OUTCOME:Amendment rejected, 42-56

Voted YES on allowing tribal Indians to opt out of federal healthcare.

TRIBAL MEMBER CHOICE PROGRAM: Members of federally-recognized Indian Tribes shall be provided the opportunity to voluntarily enroll, with a risk-adjusted subsidy for the purchase of qualified health insurance in order to--
1. improve Indian access to high quality health care services;
2. provide incentives to Indian patients to seek preventive health care services;
3. create opportunities for Indians to participate in the health care decision process;
4. encourage effective use of health care services by Indians; and
5. allow Indians to make health care coverage & delivery decisions & choices.

SUPPORTER'S ARGUMENT FOR VOTING YES:Sen. COBURN: The underlying legislation, S.1200, does not fix the underlying problems with tribal healthcare. It does not fix rationing. It does not fix waiting lines. It does not fix the inferior quality that is being applied to a lot of Native Americans and Alaskans in this country. It does not fix any of those problems. In fact, it authorizes more services without making sure the money is there to follow it.

Those who say a failure to reauthorize the Indian Health Care Improvement Act is a violation of our trust obligations are correct. However, I believe simply reauthorizing this system with minor modifications is an even greater violation of that commitment.

OPPONENT'S ARGUMENT FOR VOTING NO:Sen. DORGAN: It is not more money necessarily that is only going to solve the problem. But I guarantee you that less money will not solve the problem. If you add another program for other Indians who can go somewhere else and be able to present a card, they have now taken money out of the system and purchased their own insurance--then those who live on the reservation with the current Indian Health Service clinic there has less money. How does that work to help the folks who are stranded with no competition?

LEGISLATIVE OUTCOME:Amendment rejected, 28-67

Voted NO on adding 2 to 4 million children to SCHIP eligibility.

Proponents support voting YES because:

Rep. DINGELL: This is not a perfect bill, but it is an excellent bipartisan compromise. The bill provides health coverage for 3.9 million children who are eligible, yet remain uninsured. It meets the concerns expressed in the President's veto message [from HR976]:

1. It terminates the coverage of childless adults.
2. It targets bonus payments only to States that increase enrollments of the poorest uninsured children, and it prohibits States from covering families with incomes above $51,000.
3. It contains adequate enforcement to ensure that only US citizens are covered.

Opponents recommend voting NO because:

Rep. DEAL: This bill [fails to] fix the previous legislation that has been vetoed:

• On illegal immigration: Would the verification system prevent an illegal alien from fraudulently using another person's name to obtain SCHIP benefits? No.
• On adults in SCHIP: Up to 10% of the enrollees in SCHIP will be adults, not children, in the next 5 years, and money for poor children shouldn't go to cover adults.
• On crowd-out: The CBO still estimates there will be some 2 million people who will lose their private health insurance coverage and become enrolled in a government-run program.

Veto message from President Bush:

Like its predecessor, HR976, this bill does not put poor children first and it moves our country's health care system in the wrong direction. Ultimately, our goal should be to move children who have no health insurance to private coverage--not to move children who already have private health insurance to government coverage. As a result, I cannot sign this legislation.